Nutrition is a critical, yet often overlooked, component of chronic pain management. Food choices—how you nourish your body—and the amount of food consumed can determine how you feel and how your body reacts. Many painful conditions (carpal tunnel syndrome, rheumatoid arthritis, osteoarthritis, lower back pain, fibromyalgia, gout, migraines, headaches and more) can be improved by choosing anti-inflammatory foods and spices. Chronic pain can make life seem out of one’s control; the ability to control pain through nutrition can be a powerful, useful tool. It’s important to note that individuals who are overweight typically suffer from increased pain levels and don’t receive the same degree of pain relief from the typical treatments and interventions as individuals that are of a healthy weight.
DIET & PRESCRIPTION MEDICATION
Many people living with chronic pain take prescription medication, which may cause fluctuations in weight and appetite. A decrease in appetite can lead to skipping meals, causing a missed opportunity to consume functional nutrients that play a role in decreasing inflammation. An example of appetite-supressing medication is Topamax, commonly used for chronic migraines or back pain. Lyrica, commonly used to treat neuropathic pain and fibromyalgia, can boost appetite, resulting in overeating.
OTHER NUTRITION CHALLENGES FOR PEOPLE IN PAIN
Another challenge for people who live with chronic pain is that the pain may preoccupy thoughts and cause an individual to ignore the body’s hunger signals. Pain can also impact one’s physical abilities, making it difficult to stand for lengthy periods, shop for groceries or cook. For some suffering from chronic pain, food may be the only pleasurable aspect of a daily routine, possibly resulting in overconsumption and sub-sequent weight gain. A body suffering from a lack of nutrients as well as a body overloaded with excess weight is at risk for an intensified level of pain,a decreased benefit from pain treatments and an overall increase in systemic inflammation.
FOODS THAT PREVENT INFLAMMATION
To help to control inflammation, decrease pain and enhance quality of life, it is important to know what foods to choose. Food choices can be broken down into two categories: anti-inflammatory and pro-inflammatory foods. Anti-inflammatory foods are those rich in omega-3 fatty acids, antioxidants and phytochemicals. These include cold-water fish, a variety of spices, fruits and vegetables. Pro-inflammatory foods typically have a high glycemic load (how much the food will raise a person’s blood glucose level), contain empty calories, are highly processed, contain preservatives and are rich in omega-6 fatty acids. These include packaged foods, animal products and many oils. A diet rich in anti-inflammatory foods provides an abundance of essential nutrients without sacrificing taste or satisfaction.
INFLAMMATION, PAIN & SAD
Controlling inflammation through lifestyle modifications is a vital and integrative way to help manage pain. Obesity is considered a pro-inflammatory state that exacerbates chronic conditions and pain.
The Standard American Diet (SAD) is a term dietitians use to describe the typical American diet. The SAD is rich in refined grains, added fats and sugars. It is typically low in fiber, fruits and vegetables. The rise in the prevalence of this diet may be related to the increase in convenience foods (on-the-go eating) and consuming meals out of the home. The 2010 Dietary Guidelines for Americans indicate that the average SAD includes six ounces of equivalents of refined grains per day (50 percent more than recommended). In addition, an average of 19 percent of total calories are consumed from solid fats. Added sugars contribute an average of 16percent of total calories, including high fructose corn syrup, white sugar, brown sugar, corn syrup, corn syrup solids, raw sugar, malt syrup, maple syrup, pancake syrup, fructose sweetener, liquid fructose, honey, molasses, anhydrous dextrose and crystal dextrose.
In addition, the SAD provides an excess of omega-6 fatty acids, commonly found in refined vegetables oils such as soy, corn, cottonseed, grape seed, peanut, safflower and sunflower. These oils are inexpensive and shelf stable, making them appealing to the food industry. Fast food and processed foods like instant pastas and rice, cookies, crackers and other packaged foods are very high in these processed oils.
To reduce consumption of these pro-inflammatory oils, consumers should avoid most convenience foods sold in a pack-aged box, can or bag. A general guideline is to look for items with five ingredients or fewer; this likely eliminates many shelf-stable products and encourages eating whole foods—foods that have not been processed and are free from additives and artificial ingredients. When grocery shopping, shop the perimeter of the store and choose plenty of produce, lean meats, low-fat and fat-free dairy and whole grains. Avoid the inner aisles with highly processed foods.
Another reason to commit to making healthier choices is that the increased mechanical stress of obesity on the body overtime causes a breakdown of cartilage and production of pro-inflammatory cytokines. An increased circulation of cytokines reduces serotonin levels and can contribute to depression. Chronic pain, obesity and depression contribute to the continuation of a sedentary lifestyle. And although a sedentary lifestyle can seem to reduce pain in the short term, in the long term it may contribute to physical deconditioning, joint immobility, cartilage degradation and a greater degree of pain.
01/27/2015
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